Trivalle C, Cremieux A C, Carbon C
Service de Médecine interne, Hôpital Bichat, Paris.
Presse Med. 1995 Nov 4;24(33):1566-8.
Infections due to pneumococci are frequent in patients infected with the human immunodeficiency virus (HIV), but joint infections are rare. We observed two cases of septic arthritis due to pneumococci in two non-haemophilic HIV seropositive patients. In the first case, a 31-year old drug addict who had undergone splenectomy, developed hip joint infection during an episode of meningitis due to pneumococci. The germ was moderately sensitive to ampicillin. The second case involved the knee joint in a 29-year-old woman who developed pneumococcal pneumonia after a trip to Zaire. In both cases, joint infection developed after antibiotics had been initiated, and in the first case, after the infection appear to be under control. This would be similar to "post-infectious" arthritis described in gonococcal and meningococcal infections. In HIV positive patients, joint infections are rare compared with other types of immunodepression, but can be observed in all stages of the disease. A total of 75 cases have been reported in the literature, including 8 cases due to pneumococci. These joint infections could be another argument in favour of anti-pneumococcal vaccination in HIV positive patients.
肺炎球菌感染在感染人类免疫缺陷病毒（HIV）的患者中很常见，但关节感染却很罕见。我们观察到两例非血友病HIV血清阳性患者发生了肺炎球菌性脓毒性关节炎。第一例中，一名31岁的吸毒成瘾者接受了脾切除术，在因肺炎球菌引起的脑膜炎发作期间出现了髋关节感染。该病菌对氨苄西林中度敏感。第二例涉及一名29岁女性的膝关节，她在前往扎伊尔旅行后患上了肺炎球菌肺炎。在这两例中，关节感染均在开始使用抗生素后发生，在第一例中，感染似乎已得到控制之后仍出现了关节感染。这类似于在淋球菌和脑膜炎球菌感染中描述的“感染后”关节炎。在HIV阳性患者中，与其他类型的免疫抑制相比，关节感染很少见，但在疾病的所有阶段都可能出现。文献中总共报道了75例病例，其中8例是由肺炎球菌引起的。这些关节感染可能是支持对HIV阳性患者进行抗肺炎球菌疫苗接种的又一论据。
